This is to inform you that you are required to settle the due payment of $000 for the dental services provided by [Your Practice Name] in between [Start Date] to [End Date]. We did your dentistry in good faith that we would receive compensation for the work that we performed. Itâs just that youâre not going to file the insurance for them or the fees will be a little bit different, etc. Manager: Please accept this letter of resignation from the position of dental assistant, effective two weeks from today. Make sure to add a sentence stating that all charges or debits for payment be stopped. Active patients drop from 3,300 to 1,980 (a loss of 1,320 patients), collections drop from $115,000 to $82,800, overhead percentage drops from 70% to 58%, and profit stays the same at ⦠In this article we present 5 dental collection letter templates you can send to your patients. EOB]. We know it can be a chaotic time of the year for dental practices, so we thought weâd help you out by creating a few easy-to-use Word document templates to help you remind your patients to book appointments and avoid losing their end of year dental benefits. The next sentence should state the date when the policy is to be effectively canceled. The first letter informs the insurance company of the studentâs current enrollment status in a timely fashion, and the second letter responds to the abrupt and retroactive termination. If you are unable to pay this bill in full, please call and we can discuss setting up a payment plan. They are all written ⦠A rough draft can be typed in a text editor on a computer or a regular piece of paper. Begin the opening paragraph by requesting the cancellation of the dental insurance policy. The letter will then be mailed to the insurance company via the postal service.Â. Begin the account audit from where the ledger reads $0. Managerâs Name Managerâs Title Name of Dental Office. Dental office collection letters should never be a substitute for collection calls. If you have already sent payment in, then please, disregard this letter. «Recip_City» «Recip_State» «Recip_Zip» Especially helpful for your patients that are /pastdue/due/or ⦠We want to work with you to clear this balance as soon as possible, so please call our office and ask to speak with [Insert Coordinator Name], our financial coordinator at (123) 456-7890. Please refer to ... Employees in a plan dropping an option (Table 3) may choose a new health plan ... Benefits Administration Letter: 20-403 Author: U.S. Office of Personnel Management Subject: 2020 Federal Benefits ⦠If youâve found out that your dentist is an Out of Network provider, then youâre not alone.Itâs becoming more common for many established dental offices to stop ⦠A collection letter is an attempt to encourage patients to clear their outstanding dues. Otherwise, we look forward to receiving your payment within five days of this letter. There is a portion telling you when and how to ask for a fee increase. The dental insurance company will refund any premium that was overpaid. We will continue to accept your insurance; however we will do so as an out-of-network provider. Name on PolicyAddress of Policy HolderCity, State, Zip, XYZ Insurance CompanyAddress of CompanyCity, State, Zip. First, read over your contracts. Date. If the letter is returned unclaimed, mail it ⦠The insurer reversed their decision and paid the $125. Letter to a managed care plan to seek reimbursement for services that the patient received when time was insufficient to obtain pre-authorization because of the serious nature of the illness and the need to deal with it urgently. You can use this letter as is or customize it for your office. The next sentence should state the date when the policy is to be effectively canceled. They had received the exact same notice, and his dentist wrote the following letter to the insurance carrier. Our files indicate that your family has health insurance coverage through Bedrock Health Insurance. Make sure your dental claim has been filed with the insurance carrier. Include the contact person if addressing an agent or company representative. It’s our policy to contact patients who received a billing statement from us in the past 30 days, but have not responded. Not only was the letter funnier than all get out, it was also effective. The cash value of the policy should also be sent with any returned premium. Insurance Verification Request Form â This form is for sending out a request to the insurance company that an insurance holder will want to verify his attained policies and coverage. You are requested to contact our clinic if you have any financial difficulties regarding the amount. Make sure to send any payments that are due if the letter is not ready to send before the monthly premium due date. The dental insurance company will refund any premium that was overpaid. As per our record you have not made the payment even after our telephonic reminder on ⦠«Recip_FirstName» «Recip_LastName» The American Dental Associationâs (ADA) Council on Dental Benefit Programs (CDBP) recognized the need to further educate dentists and dental offices on the proper way to handle and respond to claim rejections from third-party payers. The next step is to prepare a rough draft of the dental insurance cancellation letter. 5 Recall Letter Templates for Inactive Dental Patients, How to Create a Great Slogan for Your Dental Practice. All the direction you need to showcase opportunity during your next job search! Remember: you need to research the professionals available through your plan and local support ⦠This is to notify you that your account with us is delinquent. Dental Patient Refund Letter #1: To Use When A Patient Has Overpaid Their Co-pay Dental Patient Refund Letters. Dentist is dropping insurance contract, or ending PPO agreement. Dear Family, After much deliberation, we have decided to end our preferred provider status with X dental insurance company, effective xxxx,xx,20xx. «Patient_FirstName» Account # «Patient_AcctNo». The first thing to state on the rough draft is the date. ... Bill patients as they come out of the treatment room, take ⦠This letter is to inform you that as of the date of this letter, I (we) will no longer be able to provide you your dental care and treatment. Pre-Paid Office # Add Drop Last First MI Sex Birth Date Student (MM DD YYYY) Social Security Number (See directory) Spouse Name M F - - - - Child Name M F Y N - - - - Child Name M F Y N - - - - Child Name M F Y N - - - - ... and I ⦠dental plan options and 10 vision plan options in 2021 for employees to review during the upcoming Open Season. 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